Patient health risk status and risk adjustment is one of many value-based care factors (including cost, utilization, and patient satisfaction) that are driving new models of physician/provider payments. Payers are utilizing Hierarchical Condition Category (HCC) codes to assess the severity of illness (risk) of patient panels. Then they adjust reimbursement-based patient risk. A payment model mandated by CMS in 1997 and originally created to estimate future costs for a patient, HCCs were designed to identify patients with serious or chronic illnesses and to then assign a risk factor score to the person based upon a combination of a patient’s health conditions and demographic details.
With Hierarchical Condition Category (HCCs) coding become much more prevalent of a topic since being implemented in 2004, ReportingMD is here to offer their Analytics for HCCs as another welcomed solution to your organization when it comes to Risk Adjust Factor (RAF) scores. Through our renowned (Total Outcomes Management) TOM™ solution, value-based care (VBC) analytics drive organizational and provider network performance while promoting development at the network and provider level regarding HCC performance/RAF scores with insights across all payers for both methodologies (CMS and HHS). Our outcomes manager module combined when used with HCC is a game changer for care management teams. Our Insights module when used with HCC’s levels the playing field for providers. The members of our dedicated advisor team are here for every question, every step of the way. Meet our team.
Learn more about ReportingMD and HCCs with the following blog posts and white papers: